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Erschienen in: Journal of Echocardiography 3/2015

01.09.2015 | Original Investigation

Longitudinal systolic strain of the bilayered ventricular septum during the first 72 hours of life in preterm infants

Erschienen in: Journal of Echocardiography | Ausgabe 3/2015

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Abstract

Background

Quantitative evaluation of right ventricular myocardial performance in preterm infants remains a challenge because of the limitations of conventional echocardiographic measurement and the complex geometry of the right ventricle (RV). Serial assessment of peak longitudinal systolic strain on the right and left sides of the ventricular septum (VS), RV, and left ventricle (LV) during the transitional period in preterm infants using two-dimensional speckle-tracking echocardiography is reported.

Methods

In 21 preterm infants (33 ± 2 gestational weeks, 1,913 ± 218 g birth weight) without mechanical ventilation, inotropic agents, or symptomatic patent ductus arteriosus (PDA), longitudinal strain (LS) was measured on both sides of the VS, RV free wall, and LV, along with conventional echocardiography at 1, 3, 6, 9, 12, 24, 48, and 72 h after birth. Correlations and factors associated with echocardiographic measurements were analyzed.

Result

LS was maintained on the four analyzed regions during the first 72 h of life despite significant hemodynamic changes, including a decrease in pulmonary artery pressure and PDA closure. LS was significantly larger on the left side of the VS than on the right side of the VS at 1, 48, and 72 h after birth.

Conclusions

Preterm infants showed stable LS on both sides of the VS, the RV free wall, and the LV despite significant hemodynamic changes during the first 72 h of life. These results suggest that the right and left sides of the VS respond differently to the complex cardiopulmonary transitions from fetal to neonatal life in preterm infants.
Literatur
1.
Zurück zum Zitat Kluckow M, Seri I. Clinical presentations of neonatal shock: the very low birth weight neonate during the first postnatal day. In: Kleinman CS, Seri I, Polin RA editors. Hemodynamics and Cardiology. Neonatology Questions and Controversies. 2nd ed. Philadelphia, Elsevier Saunders; 2012. pp. 237-67. Kluckow M, Seri I. Clinical presentations of neonatal shock: the very low birth weight neonate during the first postnatal day. In: Kleinman CS, Seri I, Polin RA editors. Hemodynamics and Cardiology. Neonatology Questions and Controversies. 2nd ed. Philadelphia, Elsevier Saunders; 2012. pp. 237-67.
2.
Zurück zum Zitat El-Khuffash AF, Jain A, Dragulescu A, et al. Acute changes in myocardial systolic function in preterm infants undergoing patent ductus arteriosus ligation: a tissue Doppler and myocardial deformation study. J Am Soc Echocardiogr. 2012;25:1058–67.CrossRefPubMed El-Khuffash AF, Jain A, Dragulescu A, et al. Acute changes in myocardial systolic function in preterm infants undergoing patent ductus arteriosus ligation: a tissue Doppler and myocardial deformation study. J Am Soc Echocardiogr. 2012;25:1058–67.CrossRefPubMed
3.
Zurück zum Zitat Lee A, Nestaas E, Liestol K, et al. Tissue Doppler imaging in very preterm infants during the first 24 h of life: an observational study. Arch Dis Child Fetal Neonatal Ed. 2014;99:F64–9.CrossRefPubMed Lee A, Nestaas E, Liestol K, et al. Tissue Doppler imaging in very preterm infants during the first 24 h of life: an observational study. Arch Dis Child Fetal Neonatal Ed. 2014;99:F64–9.CrossRefPubMed
4.
Zurück zum Zitat James AT, Corcoran JD, Jain A, et al. Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period. Early Hum Dev. 2014;90:829–35.CrossRefPubMed James AT, Corcoran JD, Jain A, et al. Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period. Early Hum Dev. 2014;90:829–35.CrossRefPubMed
5.
Zurück zum Zitat Boettler P, Claus P, Herbots L, et al. New aspects of the ventricular septum and its function: an echocardiographic study. Heart. 2005;91:1343–8.CrossRefPubMedPubMedCentral Boettler P, Claus P, Herbots L, et al. New aspects of the ventricular septum and its function: an echocardiographic study. Heart. 2005;91:1343–8.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Hayabuchi Y, Sakata M, Ohnishi T, et al. A novel bilayer approach to ventricular septal deformation analysis by speckle tracking imaging in children with right ventricular overload. J Am Soc Echocardiogr. 2011;24:1205–12.CrossRefPubMed Hayabuchi Y, Sakata M, Ohnishi T, et al. A novel bilayer approach to ventricular septal deformation analysis by speckle tracking imaging in children with right ventricular overload. J Am Soc Echocardiogr. 2011;24:1205–12.CrossRefPubMed
7.
Zurück zum Zitat Hayabuchi Y, Sakata M, Kagami S. Assessment of the helical ventricular myocardial band using standard echocardiography. Echocardiography. 2014. doi:10.1111/echo.12624. Hayabuchi Y, Sakata M, Kagami S. Assessment of the helical ventricular myocardial band using standard echocardiography. Echocardiography. 2014. doi:10.​1111/​echo.​12624.
8.
Zurück zum Zitat Di Salvo G, Russo MG, Paladini D, et al. Two-dimensional strain to assess regional left and right ventricular longitudinal function in 100 normal fetuses. Eur J Echocardiogr. 2008;9:754–6.CrossRefPubMed Di Salvo G, Russo MG, Paladini D, et al. Two-dimensional strain to assess regional left and right ventricular longitudinal function in 100 normal fetuses. Eur J Echocardiogr. 2008;9:754–6.CrossRefPubMed
9.
Zurück zum Zitat Schubert U, Müller M, Norman M, et al. Transition from fetal to neonatal life: changes in cardiac function assessed by speckle-tracking echocardiography. Early Hum Dev. 2013;89:803–8.CrossRefPubMed Schubert U, Müller M, Norman M, et al. Transition from fetal to neonatal life: changes in cardiac function assessed by speckle-tracking echocardiography. Early Hum Dev. 2013;89:803–8.CrossRefPubMed
10.
Zurück zum Zitat Jain A, Mohamed A, El-Khuffash A, et al. A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period: normative data and Z scores. J Am Soc Echocardiogr. 2014;27:1293–304.CrossRefPubMed Jain A, Mohamed A, El-Khuffash A, et al. A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period: normative data and Z scores. J Am Soc Echocardiogr. 2014;27:1293–304.CrossRefPubMed
11.
Zurück zum Zitat Levy PT, Holland MR, Sekarski TJ, et al. Feasibility and reproducibility of systolic right ventricular strain measurement by speckle-tracking echocardiography in premature infants. J Am Soc Echocardiogr. 2013;26:1201–13.CrossRefPubMedPubMedCentral Levy PT, Holland MR, Sekarski TJ, et al. Feasibility and reproducibility of systolic right ventricular strain measurement by speckle-tracking echocardiography in premature infants. J Am Soc Echocardiogr. 2013;26:1201–13.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Singh GK, Cupps B, Pasque M, et al. Accuracy and reproducibility of strain by speckle tracking in pediatric subjects with normal heart and single ventricular physiology: a two-dimensional speckle-tracking echocardiography and magnetic resonance imaging correlative study. J Am Soc Echocardiogr. 2010;23:1143–52.CrossRefPubMedPubMedCentral Singh GK, Cupps B, Pasque M, et al. Accuracy and reproducibility of strain by speckle tracking in pediatric subjects with normal heart and single ventricular physiology: a two-dimensional speckle-tracking echocardiography and magnetic resonance imaging correlative study. J Am Soc Echocardiogr. 2010;23:1143–52.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Friedman WF. The intrinsic physiologic properties of the developing heart. Prog Cardiovasc Dis. 1972;15:87–111.CrossRefPubMed Friedman WF. The intrinsic physiologic properties of the developing heart. Prog Cardiovasc Dis. 1972;15:87–111.CrossRefPubMed
14.
Zurück zum Zitat Rudolph AM. Congenital diseases of the heart. Clinical-physiological considerations. 3rd ed. West Sussex: Wiley-Blackwell: 2009. Rudolph AM. Congenital diseases of the heart. Clinical-physiological considerations. 3rd ed. West Sussex: Wiley-Blackwell: 2009.
15.
Zurück zum Zitat Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685–713.CrossRefPubMed Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685–713.CrossRefPubMed
16.
Zurück zum Zitat Mertens L, Seri I, Marek J, et al. Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training. Writing group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC). J Am Soc Echocardiogr. 2011;24:1057–78.CrossRefPubMed Mertens L, Seri I, Marek J, et al. Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training. Writing group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC). J Am Soc Echocardiogr. 2011;24:1057–78.CrossRefPubMed
17.
Zurück zum Zitat Koestenberger M, Ravekes W, Everett AD, et al. Right ventricular function in infants, children and adolescents: reference value of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr. 2009;22:715–9.CrossRefPubMed Koestenberger M, Ravekes W, Everett AD, et al. Right ventricular function in infants, children and adolescents: reference value of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr. 2009;22:715–9.CrossRefPubMed
18.
Zurück zum Zitat Kitabatake A, Inoue M, Asao M, et al. Noninvasive evaluation of pulmonary hypertension by a pulsed doppler technique. Circulation. 1983;68:302–9.CrossRefPubMed Kitabatake A, Inoue M, Asao M, et al. Noninvasive evaluation of pulmonary hypertension by a pulsed doppler technique. Circulation. 1983;68:302–9.CrossRefPubMed
19.
Zurück zum Zitat Mejia AAS, Simpson KE, Hildebolt CF, et al. Tissue Doppler septal Tei index indicates severity of illness in pediatric patients with congestive heart failure. Pediatr Cardiol. 2014;35:411–8.CrossRefPubMedCentral Mejia AAS, Simpson KE, Hildebolt CF, et al. Tissue Doppler septal Tei index indicates severity of illness in pediatric patients with congestive heart failure. Pediatr Cardiol. 2014;35:411–8.CrossRefPubMedCentral
20.
Zurück zum Zitat Colan SD, Shirali G, Margossian R, et al. The ventricular volume variability study of the pediatric heart network: study design and impact of beat averaging and variable type on the reproducibility of echocardiographic measurements in children with chronic dilated cardiomyopathy. J Am Soc Echocardiogr. 2012;25:842–54.CrossRefPubMedPubMedCentral Colan SD, Shirali G, Margossian R, et al. The ventricular volume variability study of the pediatric heart network: study design and impact of beat averaging and variable type on the reproducibility of echocardiographic measurements in children with chronic dilated cardiomyopathy. J Am Soc Echocardiogr. 2012;25:842–54.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Beyar R, Dong SJ, Smith ER, et al. Ventricular interaction and septal deformation: a model compared with experimental data. Am J Physiol. 1993;265:2044–56. Beyar R, Dong SJ, Smith ER, et al. Ventricular interaction and septal deformation: a model compared with experimental data. Am J Physiol. 1993;265:2044–56.
22.
Zurück zum Zitat Evans N, Iyer P. Assessment of ductus arteriosus shunt in preterm infants supported by mechanical ventilation: effect of interatrial shunting. J Pediatr. 1994;125:778–85.CrossRefPubMed Evans N, Iyer P. Assessment of ductus arteriosus shunt in preterm infants supported by mechanical ventilation: effect of interatrial shunting. J Pediatr. 1994;125:778–85.CrossRefPubMed
23.
Zurück zum Zitat Haruki N, Takeuchi M, Kanazawa Y, et al. Continuous positive airway pressure ameliorates sleep-induced subclinical left ventricular systolic dysfunction: demonstration by two-dimensional speckle-tracking echocardiography. Eur J Echocardiogr. 2010;11:352–8.CrossRefPubMed Haruki N, Takeuchi M, Kanazawa Y, et al. Continuous positive airway pressure ameliorates sleep-induced subclinical left ventricular systolic dysfunction: demonstration by two-dimensional speckle-tracking echocardiography. Eur J Echocardiogr. 2010;11:352–8.CrossRefPubMed
25.
Zurück zum Zitat Franchi F, Faltoni A, Cameli M, et al. Influence of positive end-expiratory pressure on myocardial strain assessed by speckle tracking echocardiography in mechanically ventilated patients. BioMed Res Int. 2013. doi:10.1155/2013/918548.PubMedPubMedCentral Franchi F, Faltoni A, Cameli M, et al. Influence of positive end-expiratory pressure on myocardial strain assessed by speckle tracking echocardiography in mechanically ventilated patients. BioMed Res Int. 2013. doi:10.​1155/​2013/​918548.PubMedPubMedCentral
26.
Zurück zum Zitat Fukuda Y, Tanaka H, Sugiyama D, et al. Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension. J Am Soc Echocardiogr. 2011;24:1101–8.CrossRefPubMed Fukuda Y, Tanaka H, Sugiyama D, et al. Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension. J Am Soc Echocardiogr. 2011;24:1101–8.CrossRefPubMed
27.
Zurück zum Zitat Giusca S, Dambrauskaite V, Scheurwegs C, et al. Deformation imaging describes right ventricular function better than longitudinal displacement of the tricuspid ring. Heart. 2010;96:281–8.CrossRefPubMed Giusca S, Dambrauskaite V, Scheurwegs C, et al. Deformation imaging describes right ventricular function better than longitudinal displacement of the tricuspid ring. Heart. 2010;96:281–8.CrossRefPubMed
28.
Zurück zum Zitat Torrent-Guasp F, Ballester M, Buckberg GD, et al. Spatial orientation of the ventricular muscle band: physiologic contribution and surgical implication. J Thorac Cardiovasc Surg. 2001;122:389–92.CrossRefPubMed Torrent-Guasp F, Ballester M, Buckberg GD, et al. Spatial orientation of the ventricular muscle band: physiologic contribution and surgical implication. J Thorac Cardiovasc Surg. 2001;122:389–92.CrossRefPubMed
29.
Zurück zum Zitat Levy PT, Mejia AAS, Machefsky A, et al. Normal ranges of right ventricular systolic and diastolic strain measures in children: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2014;27:549–60.CrossRefPubMedPubMedCentral Levy PT, Mejia AAS, Machefsky A, et al. Normal ranges of right ventricular systolic and diastolic strain measures in children: a systematic review and meta-analysis. J Am Soc Echocardiogr. 2014;27:549–60.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Takigiku K, Takeuchi M, Izumi C, et al. Normal range of left ventricular 2-dimensional strain: Japanese Ultrasound Speckle Tracking of the Left Ventricle (JUSTICE) study. Circ J. 2012;76:2623–32.CrossRefPubMed Takigiku K, Takeuchi M, Izumi C, et al. Normal range of left ventricular 2-dimensional strain: Japanese Ultrasound Speckle Tracking of the Left Ventricle (JUSTICE) study. Circ J. 2012;76:2623–32.CrossRefPubMed
Metadaten
Titel
Longitudinal systolic strain of the bilayered ventricular septum during the first 72 hours of life in preterm infants
Publikationsdatum
01.09.2015
Erschienen in
Journal of Echocardiography / Ausgabe 3/2015
Print ISSN: 1349-0222
Elektronische ISSN: 1880-344X
DOI
https://doi.org/10.1007/s12574-015-0250-8

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